Seasonal Depression Q&A: When It’s Not Just Winter Blues

As the darker days of winter days stretch on, it’s common for many people to feel unusually fatigued or down-hearted, partly due to cloudy skies and the lack of sunlight. For some, however, it’s not just run-of-the-mill winter blues, but a serious form of clinical depression known as seasonal affective disorder (SAD).

Kelly Rohan, a SAD expert with the American Psychological Association, says it’s important to recognize the differences between SAD and more typical winter blues so sufferers can seek effective treatment. In the following Q&A, excerpted from a post on the APA Website this week, Rohan explains the signs, symptoms, and remedies for the disorder.

Q: What is SAD and how is it different from winter blues or other types of depression?

A: SAD is a regular seasonal pattern of major depressive episodes during the fall and winter months with periods of full improvement in the spring and summer. The symptoms of SAD are exactly the same as non-seasonal depression symptoms, which can include a loss of interest or pleasure in normally enjoyed activities, excessive fatigue, difficulty concentrating, a significant change in sleep length, and thoughts about death or suicide. The only difference with SAD is the seasonal pattern it follows.

Q: What are the signs and symptoms of SAD?

A: The most commonly reported SAD symptoms include significant fatigue, pervasively sad mood, loss of interest in activities, sleeping more than usual, craving and eating more starches and sweets, gaining at least 5 percent of body weight, and difficulty concentrating. Most people experience SAD symptoms to a certain extent, especially at higher latitudes.

Q: Who should seek treatment for SAD?

A: If you struggle with the changing seasons, experience some of the symptoms mentioned above, have difficulty functioning at school or work or if your symptoms interfere with your ability to interact with your family or others during the winter months, you should talk to your doctor about a referral to a psychologist or find a psychologist yourself.

Q: What types of treatments are available?

A: The most widely used and extensively investigated treatment for SAD is light therapy (i.e., daily exposure to bright artificial light during the symptomatic months). Light therapy devices rigorously tested in clinical trials for SAD emit a controlled amount of cool, white fluorescent or full spectrum light with a built-in screen to filter out harmful ultraviolet rays ... When light therapy fails, antidepressant medications are widely regarded as the second line of treatment for SAD.

Q: You have been studying cognitive-behavioral therapy for SAD. How does it work?

A: The CBT for SAD treatment we have been testing includes 12 structured sessions, delivered two times per week over six weeks in the winter. The sessions focus on developing skills to improve coping with the seasons. The therapist works with the patient to foster two types of skills: behavioral (doing) skills and cognitive (thinking) skills. The behavioral skills involve identifying, scheduling and doing pleasurable, engaging activities every day in the winter. Over time, these proactive behaviors are meant to counteract the down, lethargic mood and the tendency to give in to “hibernation” urges that are so common in SAD.

Q: Can people be cured of this disorder?

A: SAD can be effectively treated but the status of the research in the field is unfortunately not at the point where we can say we have a “cure” for SAD. The good news is that research in the field shows effective treatments are available, including light therapy, medications and CBT. So there are options for people affected by SAD. There is not a one-size-fits-all treatment approach. Different things work for different people. After finding a treatment or treatments that substantially improve acute SAD symptoms in the winter, it is important that the long-term treatment plan include specific steps to try to prevent the return of SAD, or lessen its impact in subsequent fall/winter seasons.